Provider First Line Business Practice Location Address:
4200 HOSPITAL ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COAL TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17866-6267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-644-4250
Provider Business Practice Location Address Fax Number:
570-644-4572
Provider Enumeration Date:
07/11/2006